Applied Behaviour Analysis and Autism
Ranking:

Applied behaviour analysis (ABA) is a systematic way of observing someone's behaviour, identifying desirable changes in that behaviour and then using the most appropriate methods to make those changes.

It is based on the idea that someone's behaviour can be changed by altering what happens before the behaviour occurs (known as the antecedent) and /or by altering what happens after the behaviour occurs (known as the consequence).

So, for example, an ABA practitioner may try to improve a child's communication and social skills (the behaviour) by demonstrating more effective ways to interact with other children (the antecedent) and then rewarding him (the consequence) when he demonstrates the improved behaviours.

The practitioner will then analyse how well that approach has worked and, if necessary, make changes to the intervention to improve the child's behaviour next time around.

Applied behaviour analysis has been used to treat a wide range of people, including children and adults on the autism spectrum, as well as individuals with other conditions.

Our Opinion

Because there are many different interventions, programmes and techniques which incorporate the principles of applied behaviour analysis it is not possible to provide a ranking for applied behaviour analysis as a whole.

However there is strong positive evidence for some individual interventions based on the principles of applied behaviour analysis, such as some early intensive behavioural intervention programmes like the University of California at Los Angeles Young Autism Project model.

There is less strong but still positive evidence for other approaches based on the principles of applied behaviour analysis, such as incidental teaching.

Thus there is still a need for more research in some areas. For example,

Research is needed to evaluate the longer term effects of those interventions and techniques which incorporate the principles of ABA - most studies involve only relatively short follow-up periods.

There is a need for more comparative studies of interventions and techniques vs. other high quality, autism specific pre-school programmes.

Although some randomised control trials have been conducted these are small in number and the quality of the alternative intervention has not necessarily been of a high standard.

Any new research will need more focus on fidelity (of both the ABA-based interventions and the comparison interventions).There is also a need to explore in much greater detail moderators and mediators of treatment effectiveness.

In particular, the characteristics of the individuals who do, and do not, respond to intervention require systematic investigation.

Any future research should also involve people on the autism spectrum (including individuals who may be non-verbal) to review the efficacy and ethical basis of interventions based on applied behaviour analysis.

In addition, if any type of ABA is undertaken, it is important to consider any benefits against the possible impact on the child (in terms of the intensity and possible stress of the intervention) and on the families (in terms of time, finances, organisation, and effects on siblings).